Candidal meningitis in disseminated candidiasis by Candida tropicalis - A rare case report from India

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Case Report

Author Details : Naga Sri Latha Bathala*, Anjaneyulu Kammineni

Volume : 4, Issue : 4, Year : 2018

Article Page : 212-214

https://doi.org/10.18231/2455-8451.2018.0049

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Abstract

Introduction: Candida spp. are the normal flora of human body and do not cause CNS disease unless there is some immune disturbance. The prevalence of non albicans species differed significantly in various geographic areas. Candida tropicalis is a species that is now recognized as an important pathogen of debilitated individuals. 
Case Report: A 70 year old female complaining of altered sensorium since 7 days with neck stiffness. The patient was also had white plaques in the oral cavity and pharynx. MRI scan showed bilateral cerebral infarcts in pre and post central gyral regions and left thalamus. Thick curvilinear leptomeningeal enhancement along the bilateral parietal regions. Gram stain of centrifused CSF, throat swab showed presence of gram positive, yeast budding cells. Growth was curdy white on Saboraud’s dextrose agar and was negative for germ tube test. Blue colored colonies were obtained on Candida chrome agar and considered as Candida tropicalis. HIV status was negative. The patient was administered intravenous liposomal amphotericin B along with regular insulin, levitiracetam lobazam, pheytoin and potassium supplementation along with I.V. fluids. She was discharged from hospital with fluconazole maintenance dose.
Conclusion: Candida tropicalis is now recognized as an important pathogen of debilitated individuals. Subclinical candidal colonization can make the individual more prone to develop systemic infection and disease. Candida tropicalis infects meningeal layers, brain parenchyma and also involves vasculature of brain. Even though Systemic infections with Candida tropicalis may occur as terminal complications, timely evaluation, accurate diagnosis, administration of specific and supportive treatment gives good prognosis.

Keywords: Candida tropicalis, Disseminated, Meningoencephalitis, Amphotericin B.

 

How to cite : Bathala N S L, Kammineni A, Candidal meningitis in disseminated candidiasis by Candida tropicalis - A rare case report from India. IP Indian J Neurosci 2018;4(4):212-214

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